Provider Demographics
NPI:1154075448
Name:LIONWORKX HOME CARE LLC
Entity Type:Organization
Organization Name:LIONWORKX HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:MECHELLE
Authorized Official - Last Name:LUPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-692-1075
Mailing Address - Street 1:2492 MAGNOLIA RIDGE DR SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-3938
Mailing Address - Country:US
Mailing Address - Phone:404-692-1075
Mailing Address - Fax:
Practice Address - Street 1:2492 MAGNOLIA RIDGE DR SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-3938
Practice Address - Country:US
Practice Address - Phone:404-692-1075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care